Some questions have emerged about Supreme Court nominee Elena Kagan. Reason asks if she would ban books. Bloggers at the Volokh Conspiracy touch on what is arguably Kagan’s political manipulation of a medical specialty society’s statement on abortion. It should be said that the American College of Obstetrics and Gynecology comes out looking worse than the nominee.

Though the response to the Deepwater Horizon spill has arguably been insufficiently aggressive, here are two commentators who argue that children should be taught to better express and receive aggression.

What is a “scientific consensus?” Reason’s Ronald Bailey takes on this issue. Along the way, we stumble onto this gem of a web page explaining the relationship between animal models of carcinogenic toxicity and the actual exposure of humans to those substances. Much more non-technical than I made it sound. Do give it a read if only to attenuate your own “cancer panic” over some of those chemicals.

“In a similar vein, Dr. Rich tries to get at the real reason for some of the outcry directed at the results of the recent JUPITER trial (statins for primary prevention in healthy adults).”

DrRich doesn’t end up making much sense. Mainly, s/he has it out for Obama, and seems to simply try to impute motives on people he doesn’t actually know to back up the central thesis that guidelines are BAD. His/hers is not, shall we say, a dispassionate, rational examination of the facts devoid of stupendously blatant bias looking for confirmation.

They’re not. Feel free to disagree with guidelines, but they’re pretty darn valuable most of the time. I’m personally fascinated with how stringently (some) cardiologists, oncologists, endocrinologists, etc. fight their guidelines, while the HIV specialists, by and large, live by theirs. A subject for another time …

I agree with you that Dr. Rich can impute motives to people in ways that don’t always make sense. For instance, he often discusses the US government as though it’s a much more unitary entity than I believe it to be.

Unfortunately, most of Dr. Rich’s old website’s section dealing with guidelines hasn’t been ported over to the new one. I agree with you that guidelines can be valuable, but the process by which they’re formulated, and the evidence behind them, can often leave much to be desired. As such, it’s worth paying attention to how guidelines are drafted, particularly given the trend towards turning guidelines into standards.

An example of the first issue I describe would be “Mammogate,” in which the USPSTF found itself in disagreement with subspecialty professional organizations over the substance of the guidelines. There are other examples out there of competing disease/physician groups with competing guidelines for care.

As to the second, the 4 (or was it 8) hour antibiotic rule for pneumonia patients promulgated by TJC for quite some time is perhaps the classic example of a guideline that was simply bad.

Guidelines are valuable, but that doesn’t mean that they should be exempted from criticism and scepticism.